Ölçeklerin Geçerlilik ve Güvenilirliklerine İlişkin Bulgular

Até o presente momento a nossa equipe na FOUSP tem publicado estudos avaliando o impacto de problemas bucais tais como, a cárie dentária, LDT e maloclusões na QVRSB de pré-escolares (25, 27) e seus pais (26) no Brasil. Um

estudo similar foi publicado pela nossa equipe também em uma população de crianças com necessidades especiais (123).

A partir dos resultados desta tese temos acesso a um instrumento que mensura QVRSB em crianças brasileiras de 5 e 6 anos de idade de acordo com a percepção tanto de crianças quanto de pais, garantindo assim uma visão geral da realidade da criança. Da mesma maneira, conhecemos agora mais detalhadamente, algo antes não avaliado, a própria percepção do paciente sobre o impacto que a cárie dentária e as LDT têm nas suas atividades diárias, bem como, os aspectos da vida da criança que pais e mães mais conhecem podendo ser considerados respondentes secundários sobre a QVRSB dos seus filhos.

Todos estes achados são importantes e podem auxiliar na elaboração e/ou modificação de políticas de Saúde Pública no Brasil, destinando os recursos humanos, técnicos e financeiros para doenças bucais que sejam efetivamente consideradas como problemas de saúde bucal desde a percepção da própria população. Porém, pelo menos duas ações ainda devem ser realizadas, instrumentos com responsividade comprovada devem ser utilizados em estudos clínicos futuros com o objetivo de conhecer quais intervenções proporcionam uma melhor QVRSB para os pacientes, e é necessária a incorporação de medidas de QV em estudos de custo-efetividade para avaliar as diferentes intervenções e programas.

Dessa forma, os recursos institucionais ou do governo poderão ser destinados para intervenções que possuam efetividade abrangente, para a melhoria da qualidade de vida e saúde de uma população.

7 CONCLUSÕES

Pode-se concluir que:

1. A versão brasileira do SOHO-5 (Scale of Oral Health Outcomes for 5- year-old children) representa adequadamente o instrumento original em inglês, sendo que o processo de tradução e adaptação transcultural possibilitou a equivalência semântica e idiomática do instrumento.

2. A versão brasileira do SOHO-5 apresenta propriedades psicométricas satisfatórias de confiabilidade e validade podendo ser aplicada como instrumento de mensuração de QVRSB em crianças de 5 e 6 anos de idade no Brasil;

3. A versão brasileira do SOHO-5 é responsiva a mudanças clínicas após o tratamento odontológico. Tanto a versão dos pais quanto a versão de auto-relato da criança apresentam resultados satisfatórios, entretanto, a versão da criança apresenta um melhor desempenho.

4. A cárie dentária, mas não as LDT, apresenta impacto negativo na QVRSB de crianças de 5 e 6 anos de idade, de acordo com a percepção tanto de pais quanto de filhos. Ter uma renda familiar mensal acima de 3 salários mínimos melhora a QVRSB nesta faixa etária, independente do tipo de agravo bucal.

5. As mães avaliam a QVRSB dos seus filhos de 5 e 6 anos de idade de forma semelhante às crianças, enquanto que os pais tendem a subestimar os relatos. As mães podem ser preferencialmente escolhidas como respondentes dos seus filhos, mas não deve-se substituir o auto-relato da criança.

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